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本文从牛顿流体张量本构方程出发,引入stokes条件和各向同性条件而简化关系式,并考虑到胆道流动特点,认为纯剪切条件下的牛顿粘性定律可以描述胆汁流动。 作者对51例患者“T”管引流胆汁(663份标本)进行系统连续测定,发现随着术后时间的推移,胆汁粘度变化呈明显规律。手术96小时后,72.5％(37例)患者胆汁粘度明显下降且稳定在2.54×10~(-2)cm~2/s以下;而肝感染较为严重的14例(27.5％),尽管术后患者体温,脉博均在72小时左右趋于正常,一般情况较好,但由于胆汁中持续或间歇含有脓性物质,使胆汁粘度推持在较高水平或反复波动。由此可见,临床中毒症状消失并不意味着胆道感染已彻底消除;“T”管引流后,由于oddi失去其阀门作用,故不论胆囊切除与否,引流胆汁粘度无明显差异。 作者认为,用理工方法分析、测定胆汁的流动特性,将对进一步了解肝内感染控制情况,提供有益的参考,这也是生物力学在胆道疾患方面一个新的应用。
Starting from the Newtonian fluid tensor constitutive equation, the stokes and isotropic conditions are introduced to simplify the relationship. Considering the characteristics of biliary tract flow, Newtonian viscosity law can be used to describe the bile flow in pure shear. The author of 51 patients with “T” tube drainage bile (663 specimens) were systematically continuous determination and found that with the passage of time after the change of bile viscosity showed a clear law. After 96 hours of operation, the bile viscosity of 72.5% (37 cases) patients decreased obviously and stabilized below 2.54 × 10 -2 cm 2 / s, while the severity of liver infection was 14 cases (27.5%), although postoperative Patients with body temperature, pulse Bo are about 72 hours to normal, the general situation is better, but because of bile continuous or intermittent purulent substances, so that push the bile viscosity at a high level or repeated fluctuations. Thus, the disappearance of symptoms of clinical poisoning does not mean that the biliary tract infection has been completely eliminated; “T” tube drainage, due to loss of its valve oddi role, so regardless of cholecystectomy or drainage, drainage bile viscosity no significant difference. The authors believe that the use of scientific methods to analyze the flow characteristics of bile will provide a useful reference for further understanding of the control of intrahepatic infection. This is also a new application of biomechanics in biliary disorders.